Vulvodynia is classified as chronic vulvar pain with no known cause. There are variations in the location, severity and constancy of the pain for those affected. Some women have pain in numerous areas of the vulva, while others experience pain in just one. The most common symptom reported is burning with different descriptions of the pain. One woman stated the pain felt like a knife, another said it felt like her skin was being burned by acid. The two main types of vulvodynia are generalized and localized and they can co-exist.
Localized vulvodynia is when the pain is concentrated on one vulvar site. When the pain is located in the vestibule or the tissue around the opening of the vagina, it is diagnosed as vestibulodynia. The majority of women with this condition have PVD or Provoked Vestibulodynia. This is when pressure on the vestibule causes pain. This includes:
- Inserting a tampon
- Sitting for a prolonged period of time
- Wearing tight or fitted pants
- Sexual intercourse
Clitorodynia is a more uncommon form and causes severe pain in the clitoris. The classifications of PVD are primary and secondary. Women diagnosed with primary PVD have had vestibular pain since the first time they experienced vaginal penetration. Women diagnosed with secondary PVD can have sexual intercourse without pain before they develop vulvar pain.
GV or generalized vulvodynia causes spontaneous pain that is usually constant but periods of relief may be experienced. The symptoms usually become worse if pressure is applied to the vulva such as having sexual intercourse or sitting for long periods.
The Treatments for Vulvodynia
The treatments include surgery, therapy and medication. The most effective treatment for all women is combining more than one treatment. The best results occur when this combination is specifically tailored for the symptoms of each woman. Our physician will recommend the right treatment or treatments. Many women attend support groups or go to therapy due to the impact of chronic pain on their emotions.
The medication can be given by injection, topically or orally. This includes:
- Topical estrogen creams
- Nerve blocks
- Local anesthetics including lidocaine
- Serotonin-norepinephrine reuptake inhibitors
- Tricyclic antidepressants
- Anti-inflammatory medications including mast cell inhibitors or steroids
- Spinal infusion pump and neurostimulation
Alternative or complementary medicine may also be recommended by the physician.
It is important to see one of our specialists at the Fort Worth Center for Pelvic Health in Fort Worth for this condition. Our physician can provide a recommendation regarding treatment. If you are suffering from any of the different types of vulvodynia and are interested in finding out more about the available treatments, please contact us today to schedule your consultation!